Shoppers in children’s stores this month will be deluged with millions of pamphlets, posters and seminars warning them about the “hidden hazards” of putting babies in adult beds.
But while the campaign carries the seal of the Consumer Product Safety Commission, it’s actually funded by the companies that make and sell baby cribs. And it has sparked outrage among pediatricians and sleep researchers who say the brochures and posters wrongly imply that it’s safer for a baby to sleep in a crib than in a parent’s bed.
The effort has reignited debate about a fundamental but complex issue: how and where to put a child to sleep at night. Experts say as many as half of families sleep with their kids at least some of the time, a practice commonly called co-sleeping or bed-sharing. While parents in most parts of the world sleep with their children, in the U.S. there’s still a strong cultural opposition to the practice.
“Hidden hazards.” The new safety campaign, dubbed “Sweet DreamsSafe Sleep for Babies,” cites some scary-sounding statistics. It warns that babies placed in adult beds “risk suffocation from several hidden hazards.” The brochures, which are being handed out by the Juvenile Products Manufacturers Association and the retailer Babies “R” Us, cite CPSC data claiming that more than 100 children over a three-year period died after being placed on adult beds.
Based on that data, an average of about 33 babies die in adult beds each year. But the CPSC says 27 children a year suffocate as a result of some problem with a crib. In addition, 700 to 800 children die each year from SIDS, or Sudden Infant Death Syndrome, and the vast majority of those kids are in cribs.
“To mention the hundreds of babies that die in beds while failing to mention the thousands that die in cribs may please the crib manufacturers, but it does a disservice to parents who need to be taught about sleep safety wherever they choose for their babies to sleep,” says Alan Greene, a Palo Alto, Calif., pediatrician and founder of the popular parent-advice Web site drgreene.com.
Elaine Tyrrell, director of outreach programs for the CPSC, says the agency isn’t taking a stand on the issue of sleeping with a child, but simply alerting parents about the dangers of the bed itself. She says the CPSC in the past has focused on other risks, such as old cribs and soft bedding.
The JPMA, which represents makers of baby products, is spending about $175,000 on the campaign. Babies “R” Us declined to say how much it is contributing.
JPMA general counsel Rick Locker says “people have gotten the wrong impression” about the campaign because of comments three years ago by past CPSC chair Ann Brown, who said parents should never sleep with their kids. Mr. Locker says the campaign isn’t about co-sleeping, but about the “risks associated with placing infants in adult beds and leaving them unattended.”
The debate about co-sleeping erupted in 1999, when a CPSC study found that over a seven-year period, 515 children had suffered accidental suffocation while sleeping in an adult bed.
But the research has been strongly criticized by doctors and statisticians. The study didn’t use proper statistical methods so the results can’t be applied to the general population. Critical information, such as alcohol use by the parents and the baby’s sleep position, was missing. Finally, there was no way to compare the relative risk of adult beds to cribs.
Lowering the risk. In a paper published this month in Mothering magazine, one analysis of the CPSC findings attempted to gauge the overall risk of both beds and cribs by factoring in data that shows about 44% of families often sleep with their kids. The magazine article concludes that children who sleep with their parents have less than half the risk of dying of those who sleep in cribs.
Some experts speculate that children who sleep with their parents also may have a lower risk of dying from SIDS, often called “crib death.” In Japan, which has the lowest rates of infant mortality and SIDS, about 90% of parents sleep with their babies. Even so, the data on cribs vs. beds is inconclusive.
“Because we don’t really know how many babies sleep where and for how long each night, we don’t know enough to say that co-sleeping or crib-sleeping is safer,” says Dr. Greene.
Staying close to baby. It is known that babies left unattended while sleeping, regardless of the type of bed, are twice as likely to die of SIDS as babies who sleep in the same room with a caregiver, says James McKenna, director of the mother-baby behavioral sleep laboratory at Notre Dame University.
One reason: Babies who sleep near their mothers, even those in cribs, stir more frequently, potentially allowing them to take in more oxygen and protecting them from the stalled breathing that may be a factor in SIDS. In addition, a nearby caregiver is more likely to hear a baby gasping or choking.
Pediatricians and other researchers say parents should know the potential hazards of either sleep option, in part because many babies end up sleeping all over the house.
“Just because parents are putting babies in cribs doesn’t mean they aren’t also putting babies in adult beds,” says Dr. McKenna. “It’s better to prepare parents and have them know how to construct safe environments wherever their babies might be.”